RESUMO
BACKGROUND: The current use of external cervical orthoses (ECO) after cervical discectomy is still based on a common practice than a solid scientific literature. The aim of this study is to evaluate the impact of ECO on radiological and functional outcomes in patients undergoing anterior cervical discectomy and fusion (ACDF). METHODS: We compared two cohorts of consecutive patients who underwent ACDF with and without ECO after surgery. Thirty-six patients operated from January 2015 to June 2016 received an ECO whereas 36 patients, operated from July 2016 to December 2017, did not. Each patient underwent radiological and functional evaluation using plain x-ray at 1, 6, and 12 months after surgery and Neck Disability Index (NDI) at 2 weeks and 3, 6, and 12 months after surgery, respectively. RESULTS: In the ECO group, 5 patients (13.9%) presented an incomplete fusion and 31 patients (86.1%) presented a complete fusion (CI 0.705-0.953). In the non-ECO group, 8 patients (22.2%) presented an incomplete fusion and 28 patients (77.8% [CI 0.608-0.899]) had a complete fusion, with no statistically significant differences between two groups. No statistically significant differences were also observed regarding the NDI neither at 2 weeks nor at 3-, 6-, and 12-month follow-up. At multivariate analysis, patients who underwent two-level ACDF showed a five-fold increased risk of worse NDI at 3-, 6-, 12-month (p = 0.003, CI 1.770-14.584) follow-up. CONCLUSIONS: We advise against the routine use of ECO after single- or two-level ACDF as we did not find out any significant statistical differences between the two groups.
Assuntos
Vértebras Cervicais/cirurgia , Discotomia/métodos , Aparelhos Ortopédicos , Fusão Vertebral/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Resultado do TratamentoRESUMO
To determine the effects of integrative relaxation training (IRT) on emotional stability, we exposed 32 patients diagnosed with anxiety disorder to a pre-test (16PF) and to 12 sessions of group psychoeducation training. Patients were randomly assigned to 2 groups (study 17 and control 15 patients). The study group received 12 weekly group sessions of IRT. Level of anxiety was evaluated in a post-test using a questionnaire and the State-Trait Anxiety Inventory (STAI). Emotional stability and level of anxiety were significantly reduced in the study group: there was a marked increase in scores for emotionally s and venturesome and a decrease in scores for apprehensive and tense. The STAI score was statistically significantly lower in the study group.
Assuntos
Transtornos de Ansiedade/terapia , Educação de Pacientes como Assunto/organização & administração , Psicoterapia de Grupo/organização & administração , Terapia de Relaxamento/organização & administração , Adaptação Psicológica , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Atitude Frente a Saúde , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Entrevista Psicológica , Irã (Geográfico) , Estilo de Vida , Masculino , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Espiritualidade , Inquéritos e Questionários , Resultado do TratamentoRESUMO
To determine the effects of integrative relaxation training [IRT] on emotional stability, we exposed 32 patients diagnosed with anxiety disorder to a pre-test [16PF] and to 12 sessions of group psychoeducation training. Patients were randomly assigned to 2 groups [study 17 and control 15 patients]. The study group received 12 weekly group sessions of IRT. Level of anxiety was evaluated in a post-test using a questionnaire and the State-Trait Anxiety Inventory [STAI]. Emotional stability and level of anxiety were significantly reduced in the study group: there was a marked increase in scores for emotionally s and venturesome and a decrease in scores for apprehensive and tense. The STAI score was statistically significantly lower in the study group
